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NPI 1962440016

NPI 1962440016 : GEORGE ALBERT HIGGINS CRNA : LOS ANGELES, CA

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General NPI Number Information
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    NPI Number           |    1962440016
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    Entity Type          |    Individual 
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    Provider Name        |    GEORGE ALBERT HIGGINS CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/02/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    11301 WILSHIRE BLVD BLDG 500
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90073-1003
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    Country              |    US
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    Telephone            |    310-268-3221
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11301 WILSHIRE BLVD BLDG 500
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90073-1003
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    Country              |    US
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    Telephone            |    310-268-3221
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    NA 1914
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    License Number State |    CA
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